Though not well known in the US, Andrographis paniculata is deserving of a reputation equaling that of Echinacea as a botanical treasure for the treatment of colds, flu and a host of other common ailments. Known as chuan xin lian, meaning, “thread the heart lotus” in Chinese, andrographis is one of the more powerful of the anti-infectious herbs of Chinese medicine1. In Thailand, andrographis is formally included in the National List of Essential Drugs, predominantly for the relief of cold symptoms2. The botanical also figures prominently in at least 26 ayurvedic formulas in India3, demonstrating that its use throughout Asia is very broad. Considering the impact that colds and flu have around the world and the potential for worldwide flu pandemics with SARS and the avian bird flu, it is easy to understand why an herb like andrographis would be so valued.

Traditional Chinese UseIn Chinese medicine, andrographis can be considered a superstar amongst a materia medica of more than 1,000 botanicals. It is one of the primary botanicals used for infections, primarily of the lungs, throat, skin and urinary tract and, like echinacea, has even been historically used for the bites of venomous snakes. It is classified as a very cold herb that therefore is used for treating conditions associated with heat, such as fever, a dry, wheezing cough, inflamed throat and sinuses, and inflammation of the stomach and intestines. When concerns regarding SARS hit in 2002, andrographis quickly became one of the most widely sold botanicals in Hong Kong and Mainland China. Even the World Health Organization regards andrographis both as a preventive and treatment for upper respiratory infections, cold, sinusitis, bronchitis, tonsillitis, lower urinary tract infection and acute diarrhea4, the latter of which is another killer worldwide.

Flu and Upper Respiratory InfectionsTreatment of flu in conventional medicine is largely symptomatic with recommendations to increase fluids, get plenty of rest, and take Tylenol (acetaminophen) for reducing fever and muscle aches. Other symptomatic treatments such as antitussives (for cough), expectorants or nasal decongestants may also be recommended.

One multi-center randomized controlled trial of andrographis with Tylenol was conducted in Thailand. In patients who took the combination, fever and the severity of all other symptoms except for cough, were more greatly relieved than treatment with Tylenol alone. Another study showed the benefit of andrographis for the treatment of upper respiratory infections, the relief of fever and tonsillitis, and reduction in the severity of cold symptoms (e.g. phlegm, stuffy nose, headache, tiredness, earache, sleeplessness and sore throat)2. Two systematic reviews confirmed the efficacy of andrographis for the treatment of upper respiratory infections5,6, while a highly critical evidenced-based review rated andrographis as having “strong scientific evidence” supporting its use in upper respiratory infections7. Other studies have reported andrographis to successfully treat pneumonia8.

In addition to its demonstrated efficacy in a variety of studies, 80 percent of the patients who took andrographis in combination with Tylenol were satisfied with the results and said they would take the combination again, while only 20 percent of those who only took Tylenol said they would use it again.

Andrographis—Chemistry and PharmacologyThe primary constituents of interest in andrographis are a group of diterpenoids known as andrographolides. Andrographolides are responsible for the intense bitter flavor and primary medicinal effects of the herb. In vitro and animal studies demonstrate a variety of actions that support the primary uses of andrographis for infectious conditions. These include anti-inflammatory, antipyretic, antiviral, immunomodulatory, antioxidant and anti-diarrhea activity. The mechanisms most often associated with the antiviral actions are an increase in macrophage activity, which scavenge and destroy invaders.

Other UsesThere are a myriad of other uses of andrographis that are worthy of mention. Most significantly is its potential as an anticancer agent. Numerous studies have reported on the ability of andrographolides to both directly kill cancer cells as well as cause cancer cells to mature and differentiate, which helps prevent the cancer from spreading out of control. Studies have shown that andrographolides can block the growth of breast cancer, prostate cancer and non-Hodgkin’s lymphoma8. Andrographolides have also been shown to interrupt or modify the cellular signaling transduction pathways of the HIV virus, which basically means it can slow the progression of the virus, potentially lessening viral load. Two other primary mechanisms associated with this antiviral activity were the ability to produce antibodies to counter the attack of invading microbes; and the enhancement of macrophage activity to scavenge and destroy pathogenic invaders. Another study showed that andrographolide could increase CD4(+) lymphocytes in HIV-infected individuals, suggesting that andrographis is a potential adjuvant in anti-HIV therapies8.

Another primary use of andrographis is for acute diarrhea, which remains one of the top ten causes of death worldwide. Bitter substances (e.g. coptis, berberine) in general have historically been used for intestinal inflammation and infectious diarrhea specifically. Andrographis extracts have been shown to elicit strong antimicrobial activity against E. coli associated diarrhea and bacillary dysentery8.

By Roy Upton, Registered Herbalist

How to Take In Chinese medicine, andrographis is predominantly used in combination with other botanicals. More recently it has been used alone as a Western magic bullet for cold and flu symptoms, and is often combined with echinacea. As a stand alone, andrographis can be used in capsule, tablet or liquid extract form (if you can get past the intensely bitter taste), either as a crude herb or chemically characterized extract. The typical dosage of crude herb or extract for acute use is from 3-6g; or 6-12mL of a liquid extract (e.g. 1:2). Most extracts are chemically characterized to a specific percentage of andrographolides (e.g. six to nine percent).

Like most botanicals that are used for cold and flu, andrographis is most effective when taken as soon as symptoms start coming on so it is important to have it on hand as a staple in your medicine cabinet. Andrographis also can figure prominently in the treatment of other infections or potential infections one might have, such as from a cut or puncture wound, though common sense dictates that you seek medical attention when necessary.

SafetyGenerally speaking andrographis is considered to be a very safe botanical when used appropriately. In a critical evidenced based review5 adverse events were generally mild and infrequent and spontaneous reporting to pharmacovigilance programs internationally report few adverse events associated with andrographis. However, there are two primary concerns of which to be aware. The first is that it is used in various parts of India as an oral contraceptive for men and women and an abortifacient for women. In men, andrographis appears to either decrease sperm production or have an antiandrogenic effect. In females, andrographis may prevent ovulation and inhibit progesterone production, though this has only been speculated, and also may cause miscarriage8. Therefore, couples trying to become pregnant should not use andrographis. Additionally, substances such as andrographis, which possess a strong antibacterial or antiviral activity and are generally used for acute infections, are generally not used for long periods of time. As with classical antibiotic regimens it is best to use andrographis for no more than 10 days unless specifically recommended by a qualified health care professional, ideally a traditional Chinese medical practitioner. If symptoms are not resolved within 10 days it is likely that andrographis is not appropriate and more specific help is needed.

Andrographis’s FutureIt is difficult to predict if andrographis will ever reach the superstar status of echinacea, milk thistle, ginseng and St. John’s wort. However, there is no doubt it will achieve “staple” status on the shelves of health food stores, at least amongst those more knowledgeable of its benefits. There is also no doubt that natural medicine practitioners of all disciplines will continue to learn about andrographis and apply it to its full therapeutic benefit, thus bringing it to the attention of more and more consumers. VR

A noted author and lecturer trained in both Western and Traditional Chinese herbalism, Roy Upton is the executive director and editor of the American Herbal Pharmacopoeia, an organization dedicated to the development of quality control standards for botanical medicines. A professional herbalist for more than 27 years, Upton is also vice president of the American Herbalists Guild; is director of the herbal company Planetary Herbals; is a member of the Standards Committee of the American Herbal Products Association; and serves on expert advisory committees of AOAC International, NSF International and the United States Pharmacopeia.

Printed with permission from Vitamin Retailer Magazine

KOLD KARE® , Cold, Flu, Sinusitis & Allergy Relief - Andrographis paniculata, the active ingredient in KARE-N-HERBS exclusive KOLD KARE , has proven to be an effective prophylactic against the common cold, flu and sinusitis. Double-blind clinical study has proven that recovery from fever and cold is faster with Andrographis paniculata. The active principle of Kold Kare tablets is bacteriostatic and virostatic, reducing tiredness by 30%, shivering by 50%, sore throat by 40%, muscular ache by 48%, and sinus pain and headache by 30% in comparison to control groups who took placebos.

Kold Kare is a natural herbal dietary supplement that acts naturally against colds, flu, allergies and acute uncomplicated sinusitis. Formulated exclusively from the natural shrub Andrographis paniculata, used in China and India as a natural defense against respiratory diseases and irritation and general side effects.

At the first sign of a cold, take 4 tablets per day for 6 days. If you have a cold already, take 4 tablets a day for 10 days. To prevent cold, take 2 tablets twice daily. To help sinusitis problems, take 2 to 4 tablets every day.